Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | CNP161143 | ME |
Y | 363LA2100X | Nurse Practitioner - Acute Care | CNP161143 | ME |
NPI | 1003366709 |
---|---|
Provider Name | Patricia Mae Wieler |
First Address | Augusta, ME 04330-8160 |
Second Address | Portland, ME 04102-3112 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2016 |
Last Update Date | 26/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003366709 | (05) | ME |